1 | INTRODUCTION
The COVID-19 pandemic, also known as the coronavirus pandemic, is an
ongoing pandemic of viral infection caused by severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2). The outbreak was first emerged in
Wuhan, China in December 2019. Global confirmed cases of COVID-19 have
been reached over 10 million (Worldometeter.info 2020), and people
around the world are facing extraordinary changes to their daily life
due to the restrictions imposed to slow the spread of virus. The
majority of countries around the world, including Pakistan, find
themselves between two circumstances: the economic well-being and
medical care of the population, both of which are threatened by
”Covid-19” virus. Leaders across the globe are facing this dangerous
situation and making decisions about lifting lockdown policies, with
anticipated healthcare, environmental, socio-economic, and political
consequences (Gilbert et al. 2020).
According to recent COVID-19 spread data, Pakistan has not only passed
the neighboring China but also ranked 12th country
with highest COVID-19 confirmed cases (Worldometeter.info 2020). The
nationwide tally of Covid-19 patients stands at 198,833 with 72,880
cases in Punjab, 76,318 in Sindh, 24,943 in Khyber-Pakhtunkhwa, 10,116
in Balochistan, 1,417 in Gilgit-Baltistan, 12,206 in Islamabad and 1,003
in Azad Jammu and Kashmir, as of June 28, 2020, 07:25 GMT+5
(Covid.gov.pk 2020).
In response to the COVID-19 pandemic, in addition to the more routine
public health measures, Pakistan implemented “lockdown”, as an
important tool to curb virus spread. On February 26, Pakistan reported
its first case of COVID-19 in Karachi, the capital city of Sindh
province. On March 13, the federal government announced a nationwide
response, including closing borders with Iran and Afghanistan,
prohibiting large public gatherings, closing schools, screening of
passengers at airports, and establishment of isolation centers with
basic facilities. A few days later, the province of Sindh went into
complete lockdown while Punjab partially started from March 24. The
military supported provincial governments, in the implementation of
stringent measures to deal with the spread of the virus.
As the situation develops, Pakistan’s main concern was to balance public
health needs with the pressure COVID-19 places on its already weak
economy. Despite criticism from medical professionals and opposition
politicians, the Prime Minister of Pakistan Imran Khan has continued to
ease lockdown restrictions saying the country’s ailing economy would
collapse and the poorest among the country’s 220 million would die of
hunger. Eventually, on May 9, Pakistan’s government eased a
nationwide lockdown initially imposed as a preventive measure against
the COVID-19 spread. The decision to lift lockdown in Pakistan was
largely influenced by its socio-economic structure. The livelihood of
majority of Pakistanis depend on the informal sector (Ahmad 2020).
Already, as many as 30 percent Pakistanis are living at or below the
World Bank’s poverty line of USD 1.90 a day. There are anxieties that
people may die from other non-pandemic deaths (Mamun and Ullah 2020) if
the national economy went into a crash due to prolonged lockdown
restrictions.
Researchers have reported positive contributions of lockdown to various
COVID-19 outcomes. For example, a study from China concluded that
lockdown measures significantly reduce growth rate and increase doubling
time of COVID-19 cases (Lau et al. 2020). Another study from China used
province level data and found that social distancing measures are
effective in reducing virus infection and deaths (Figueiredo et al.
2020). In developed countries, restriction policies were found to be
efficient in reducing contact rate and the number of infectious cases
(Roques et al. 2020). Some studies have also analyzed the impact of
lockdown measures on environmental indicators (Berman and Ebisu 2020;
Cadotte 2020; Cole, Elliott, and Liu 2020; Fan et al. 2020; Gupta,
Tomar, and Kumar 2020; Ward, Xiao, and Zhang 2020; Xu et al. 2020).
While, no study has yet reported the health implications of lifting
lockdown. Given this, the aim of this study is to evaluate whether
lockdown lifting has the potential to speed-up the virus’ spread and
deaths. In this current environment, it is crucial to understand and
assess the effect of these measures and policies, as their consequences
remains unclear.